Radical vulvectomy combined with elective node irradiation for TxN0 squamous carcinoma of the vulva
✍ Scribed by James W. Daly; Rodney R. Million
- Publisher
- John Wiley and Sons
- Year
- 1974
- Tongue
- English
- Weight
- 420 KB
- Volume
- 34
- Category
- Article
- ISSN
- 0008-543X
No coin nor oath required. For personal study only.
✦ Synopsis
T h e conventional treatment for squamous carcinoma of the vulva with negative nodes (No) is radical vulvectomy and bilateral node dissections. Approximately 20-3096 of No p-atients will have involved nodes in the surgical specimen.
The morbidity/mortality added by the node dissections may be considerable, especially for the two of three patients who are not aided by t h e procedure.
Radical vulvectomy followed by elective node irradiation of 4500 R in 5 weeks has been used in six patients. The treatment combination is well tolerated with no node failures, no radiation complications, no delay in healing of the surgical site, and a n average hospitalization of 13 days.
C~PZCCT 34:161-165, 1974.
ARCINOMA OF THE VULVA IS A DISEASE OF
C senescence, although it does occasionally occur in the younger woman. It is not a common tumor, comprising only 3 4 y 0 of all genital neoplasms in the female. Ninety-five percent of the lesions are squamous cell in origin. T h e regional spread follows predictable pathways; distant metastases occur only late and as a result of uncontrolled local or regional disease.
As late as 1939 the cure rates of carcinoma of the vulva were as low as 15y0. Taussigll in this country and Stanley Way12 in England pioneered our knowledge of the disease and demonstrated that complete excision of the vulva and removal of the inguinal and perhaps the pelvic nodes would markedly increase the survival rate. At the present time with vulvectomy and bilateral surgical removal of the regional nodes, the 5-year survival rate is reported to be about 60% of all patients. Those patients without metastasis to the nodes have an 85y0 chance of cure, whereas those with positive nodes have a 30% 5-year cure rate.2